Editorial

Making systematic reviews global

Lisa Bero & Davina Ghersi16 February 2011

On January 24 2011, the World Health Organization (WHO) executive board awarded The Cochrane Collaboration the status of a non-governmental organisation (NGO) in official relations with the WHO, establishing a partnership with formalised communication between the two organisations.[1] In this editorial we reflect on the importance of this step and the opportunities that it implies.

The decision to formalise the relationship between these two, complex organisations is the result of many years of informal, ad-hoc collaboration on a number of projects and programmes. An early example of the Cochrane-WHO partnership was the WHO Reproductive Health Library (RHL), launched in 1997. This online review journal has provided universal free access to Cochrane Reviews that consider aspects of sexual and reproductive health. This has offered actionable and practical advice to clinicians, policy-makers and consumers, with the aim of improving health outcomes, particularly in low- and middle-income countries (LMICs).

Building relationships between the two organisations serves a number of purposes:

Advancing the use of evidence to inform health care and health policy decision-making

Ensuring that reviews are conducted that are directly relevant to LMICs

Building research capacity in LMICs.

Since the introduction of RHL, there have been many other projects and programmes where individuals and groups from The Cochrane Collaboration and the WHO have worked together. The Evidence in Practice Network (EVIPnet) and the production of SUPPORT summaries of Cochrane Reviews aimed at policy-makers in resource-poor settings are examples of projects aimed at improving the use of evidence to inform health care decisions.

Collaboration with the WHO will enable The Cochrane Collaboration to extend its reach to countries where its impact may currently be limited. Individuals and groups within Cochrane who work with the WHO to produce relevant reviews and who participate in capacity-building activities, such as workshops and co-authoring reviews with WHO staff, are making a valuable contribution towards ensuring that WHO recommendations are based on sound evidence. Cochrane collaborators have conducted specific reviews and review updates aimed at supporting the creation of specific WHO guidelines, as well as the Essential Medicines List. This has been accompanied by the WHO's adoption of the GRADE tool, whenever possible, for evaluating the quality of evidence for supporting the production of evidence-based recommendations. Cochrane collaborators have also provided training to WHO-affiliated staff in the use of GRADE and interpretation of systematic reviews. This work has extended to the development of country-specific guidelines in WHO member states. Current plans include a library of evidence for nutrition interventions, including relevant Cochrane Reviews.

At its forthcoming mid-year meeting in Split, Croatia, the Collaboration will develop strategies for increasing engagement and participation across the globe. One aspect of this will certainly include consideration of how Cochrane can most effectively support the WHO in delivering evidence-based health care and health policy in LMICs.

Author information

1Lisa Bero; 2Davina Ghersi

1Professor Lisa Bero, Department of Clinical Pharmacy, and Institute for Health Policy Studies, University of California, San Francisco, USA; Co-director, San Francisco Branch of the US Cochrane Center.

Declarations of interest

The authors have completed the Unified Competing Interest form at www.icmje.org/coi_disclosure.pdf (available on request) and declare (1) no receipt of payment or support in kind for any aspect of the article; (2) that L Bero has received payment for service on the World Health Organization (WHO) Expert Committee for the Selection and Use of Essential Medicines and the WHO Guidelines Review Committee, and otherwise no financial relationships with any entities that have an interest related to the submitted work; (3) that D Ghersi is employed by the WHO, and otherwise that the authors/spouses/partners/children have no financial relationships with entities that have an interest in the content of the article; and (4) that L Bero served as an (unpaid) member of the Cochrane Collaboration Steering Group for 12 years, and that D Ghersi served as an (unpaid) member of the Cochrane Collaboration Steering Group for 6 years, and is currently joint coordinating editor of the Cochrane Breast Cancer Group (unpaid), co-convenor of the Cochrane PMA Methods Group (unpaid), and is involved as a reviewer or referee in a number of Cochrane entities (unpaid). D Ghersi is also involved in a number of WHO guidelines (as part of her employment).